Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.
Each newborn delivered in Texas must receive two screenings to test for genetic and heritable disorders. Per TAC Title 25, Part 1, Chapter 37, Subchapter D, Rule §37.56, the second screening must occur between one and two weeks of age. If the newborn is not in the hospital, the physician or health care practitioner who attends the newborn outside of the hospital is responsible for completing this screening. This is a mandatory component of a Texas Health Steps (THSteps) medical checkup.
Providers that perform a newborn screening (NBS) can order supplies by submitting an Order Form for Newborn Screening Supplies to the Department of State Health Services (DSHS) laboratory. Only the specimen collection form (NBS 3), mailing envelope, and provider address labels are provided. Lancets, mailing, and shipping costs are the responsibility of the submitter. To receive an Order Form for Newborn Screening Supplies, medical providers can call 1-512-776-7661 or 1-888-963-7111, ext. 7661, or download the form online through the DSHS web page.
For more information, call the TMHP Contact Center at 800-925-9126.